Epilepsy Severity Is Associated With Head Circumference and Growth Rate in Infants With Tuberous Sclerosis Complex.


Journal

Pediatric neurology
ISSN: 1873-5150
Titre abrégé: Pediatr Neurol
Pays: United States
ID NLM: 8508183

Informations de publication

Date de publication:
07 2023
Historique:
received: 25 08 2022
revised: 05 02 2023
accepted: 23 03 2023
pmc-release: 01 07 2024
medline: 16 6 2023
pubmed: 30 4 2023
entrez: 29 4 2023
Statut: ppublish

Résumé

Abnormal brain growth in tuberous sclerosis complex (TSC) reflects abnormalities in cellular proliferation and differentiation and results in epilepsy and other neurological manifestations. Head circumference (HC) as a proxy for brain volume may provide an easily tracked clinical measure of brain overgrowth and neurological disease burden. This study investigated the relationship between HC and epilepsy severity in infants with TSC. Prospective multicenter observational study of children from birth to three years with TSC. Epilepsy data were collected from clinical history, and HC was collected at study visits at age three, six, nine, 12, 18, 24, and 36 months. Epilepsy severity was classified as no epilepsy, low epilepsy severity (one seizure type and one or two antiepileptic drugs [AEDs]), moderate epilepsy severity (either two to three seizure types and one to two AEDs or one seizure type and more than three AEDs), or high epilepsy severity (two to three seizure types and more than three AEDs). As a group, children with TSC had HCs approximately 1 S.D. above the mean World Health Organization (WHO) reference by age one year and demonstrated more rapid growth than the normal population reference. Males with epilepsy had larger HCs than those without. Compared with the WHO reference population, infants with TSC and no epilepsy or low or moderate epilepsy had an increased early HC growth rate, whereas those with severe epilepsy had an early larger HC but did not have a faster growth rate. Infants and young children with TSC have larger HCs than typical growth norms and have differing rates of head growth depending on the severity of epilepsy.

Sections du résumé

BACKGROUND
Abnormal brain growth in tuberous sclerosis complex (TSC) reflects abnormalities in cellular proliferation and differentiation and results in epilepsy and other neurological manifestations. Head circumference (HC) as a proxy for brain volume may provide an easily tracked clinical measure of brain overgrowth and neurological disease burden. This study investigated the relationship between HC and epilepsy severity in infants with TSC.
METHODS
Prospective multicenter observational study of children from birth to three years with TSC. Epilepsy data were collected from clinical history, and HC was collected at study visits at age three, six, nine, 12, 18, 24, and 36 months. Epilepsy severity was classified as no epilepsy, low epilepsy severity (one seizure type and one or two antiepileptic drugs [AEDs]), moderate epilepsy severity (either two to three seizure types and one to two AEDs or one seizure type and more than three AEDs), or high epilepsy severity (two to three seizure types and more than three AEDs).
RESULTS
As a group, children with TSC had HCs approximately 1 S.D. above the mean World Health Organization (WHO) reference by age one year and demonstrated more rapid growth than the normal population reference. Males with epilepsy had larger HCs than those without. Compared with the WHO reference population, infants with TSC and no epilepsy or low or moderate epilepsy had an increased early HC growth rate, whereas those with severe epilepsy had an early larger HC but did not have a faster growth rate.
CONCLUSIONS
Infants and young children with TSC have larger HCs than typical growth norms and have differing rates of head growth depending on the severity of epilepsy.

Identifiants

pubmed: 37119787
pii: S0887-8994(23)00095-4
doi: 10.1016/j.pediatrneurol.2023.03.015
pmc: PMC10330061
mid: NIHMS1887771
pii:
doi:

Substances chimiques

Anticonvulsants 0

Types de publication

Observational Study Multicenter Study Journal Article Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

26-32

Subventions

Organisme : NICHD NIH HHS
ID : P50 HD105351
Pays : United States
Organisme : NINDS NIH HHS
ID : U01 NS082320
Pays : United States
Organisme : NINDS NIH HHS
ID : U54 NS092090
Pays : United States
Organisme : NINDS NIH HHS
ID : P20 NS080199
Pays : United States

Informations de copyright

Copyright © 2023 Elsevier Inc. All rights reserved.

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Auteurs

Alexis Levine (A)

Department of Neurology, Boston Children's Hospital, Harvard Medical School, Harvard University, Boston, Massachusetts. Electronic address: alevine220@gmail.com.

Peter Davis (P)

Department of Neurology, Boston Children's Hospital, Harvard Medical School, Harvard University, Boston, Massachusetts.

Bo Zhang (B)

Department of Neurology, Boston Children's Hospital, Harvard Medical School, Harvard University, Boston, Massachusetts.

Jurriaan Peters (J)

Department of Neurology, Boston Children's Hospital, Harvard Medical School, Harvard University, Boston, Massachusetts; Division of Epilepsy and Clinical Neurophysiology, Boston Children's Hospital, Harvard Medical School, Harvard University, Boston, Massachusetts.

Rajna Filip-Dhima (R)

F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Harvard University, Boston, Massachusetts.

Simon K Warfield (SK)

Computational Radiology Laboratory, Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.

Anna Prohl (A)

Computational Radiology Laboratory, Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.

Jamie Capal (J)

Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

Darcy Krueger (D)

Department of Neurology and Rehabilitation Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.

E Martina Bebin (EM)

Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama.

Hope Northrup (H)

Department of Pediatrics, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas.

Joyce Y Wu (JY)

Division of Pediatric Neurology, University of California at Los Angeles Mattel Children's Hospital, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California.

Mustafa Sahin (M)

Department of Neurology, Boston Children's Hospital, Harvard Medical School, Harvard University, Boston, Massachusetts; F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Harvard University, Boston, Massachusetts; Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Harvard University, Boston, Massachusetts. Electronic address: Mustafa.sahin@childrens.harvard.edu.

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Classifications MeSH